Blood draws are driving me crazy...

[Ado Annie, ASN, RN]

6 months in, I'm working nights. Managing my time better for the most part, but drawing blood every morning is soooo frustrating. Sometimes it goes well. Sometimes, I can't hit the broad side of a barn. So I end up devoting waaay too much time to it, and then I get behind with other tasks, including checking lab results on the patients whose labs I did get sent in. The day shift nurses get irritated when things aren't done; they always seem to be looking for things I did wrong, anyway, and this just gives them fuel.

On top of all this, it seems mean to keep sticking a patient when I'm just not getting it. Have looked up info online about venipuncture in an effort to understand what I'm doing wrong, but ... still. This is a daily task (usually for every patient), whereas IV starts are less frequent on this shift. Oddly enough, I've had less trouble with them.

Help???

[LoveSbux]

Are you using butterfly needles or straight needles?

I prefer butterflies; it's similar to starting an IV in that you see that flash. I'm not very good at using a straight needle.

[Ado Annie, ASN, RN]

Mostly I use a butterfly. I bought a phlebotomy book today and have been reading it, wondered if a straight needle might work better, but decided not. How much do those vein-finder lights cost? :-)

[dirtyhippiegirl, BSN, RN]

I'm jealous that you're good at IV starts!

I posted a few weeks ago about sucking at sticking people. I'm getting a little bit better. Don't have too much advice to offer you than the obvious stuff, although random stuff I've discovered:

don't discount drawing from an IV unless contraindicated. I always tourniquet that sucker and then fiddle with the catheter hub a bit to see if I'll get blood back, the trick being to pull back a little bit on the catheter hub and then wiggle it from side to side. I've drawn blood off 22s in hands that were a couple of days old.

Ask where the patient usually gets stuck for blood draws. Ask the other nurses. Ask the patient. Look at where others have been sticking. Sometimes the best spot to poke simply is where everyone else has been poking. Hurts more? Yeah, probably. But better than having to get stuck multiple times.

I know this might be hard to do 'cause blood draws tend to come at the busiest time of the night, but don't underestimate taking your time. I think that is one of my biggest issues. I tend to start getting anxious when I don't see a big ol' barn door AC just pulsating at me right off the bat. So then I start to hurry, stick a less then ideal vein, and then feel ashamed when I have to call in a coworker who finds a GREAT vein to stick right off the bat. Only it was on the other side of the patient and I hadn't thought about that, y'know?

[tablefor9, RN]

Shop around...and not for the transilluminator. Look at both sides,hands to ACs, just like you do for IVs. Try starting your blood draws an hour early, like right after 3am VS.

For some LOP, very fragile veins, the tourniquet may be what the problem is...try without it.

Put a warm compress on before you stick...about 10 min will do it.